Background
Although COPD is a risk factor for cardiovascular disease (CVD) and knowing that risk stratification for primary prevention of CVD is important, little is known about the actual risk of CVD in people with COPD without a history of CVD. This knowledge would inform CVD management for people with COPD.
The current study aimed to examine the risk of major adverse cardiac events (MACE, including acute myocardial infarction, stroke, or cardiovascular death) in a large, comprehensive real-world population with COPD without prior CVD.
Methods
We conducted a retrospective population cohort study using administrative health, medication, laboratory, electronic medical records, and other data from Ontario, Canada.
People without a history of CVD with and without physician-diagnosed COPD were followed between 2008 and 2016, and cardiac risk factors and comorbidities were compared. Sequential cause-specific hazard models adjusting for these factors determined the risk of MACE in people with COPD.
Results
Among ~5.8 million people in Ontario aged 40 years and older without cardiovascular disease, 152,125 had COPD. After adjustment for cardiovascular risk factors, comorbidities, and other variables, the rate of MACE was 25% higher in people with COPD than in people without COPD (HR = 1.25, 95% CI [1.23, 1 ,27]).
Conclusions In a large real-world population without CVD, people with physician-diagnosed COPD were 25% more likely to have a major cardiovascular event, after adjustment for CVD risk and other factors. This rate is comparable to the rate in people with diabetes and calls for more aggressive primary prevention of CVD in the COPD population. |
